By replacing CA 125 with a multivariate index assay (OVA1 blood test, Vermillion Inc), researchers showed the potential of a modified version of the American College of Obstetricians and Gynecologists guidelines to identify more ovarian malignancies before surgery. The modified guidelines detected almost 80% of all missed malignancies and more than 90% of missed epithelial ovarian cancers. The new guidelines, however, decreased specificity and positive predictive value.
The researchers concluded that any one of these 4 guideline modifications warrants referral to a gynecologic oncologist:
- Nodular or fixed pelvic mass on examination
- Ascites
- Evidence of abdominal or distant metastasis on imaging
- Multivariate index assay test–positive.
The full study, is published online in the June edition of Obstetrics & Gynecology (http://journals.lww.com/greenjournal/pages/default.aspx).